Discover and read the best of Twitter Threads about #ipaa
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@MondayNightIBD @Spencerkelley7 1/
👋 to this week’s #MondayNightIBD with the #Back2Basics #B2B team
🦠 Today we are discussing #Cdifficile infection in #IBD
Stay tuned to 📝 more about #CDI :
➡️ #IBD vs. general 👩👨🦱
➡️ diagnosis
➡️ treatment options
👋 to this week’s #MondayNightIBD with the #Back2Basics #B2B team
🦠 Today we are discussing #Cdifficile infection in #IBD
Stay tuned to 📝 more about #CDI :
➡️ #IBD vs. general 👩👨🦱
➡️ diagnosis
➡️ treatment options
@MondayNightIBD @Spencerkelley7 @dunleavy_katie @SanjeevaniTomar @yaransarkis @RomyChamoun @BassiMehak @JosephHabibi_MD @DCharabaty @DSTEINGIMD @BeniwalPatelMD 2/
#CDI in #IBD compared to general 👩👨🦱
⬆️⬆️ common (5-8x 🔺)
⬆️ community-acquired
⬆️ w/o antibiotic 💊 exposure
⬆️ colonization
⬆️⬆️ recurrence ☹️
⬆️ colectomy risk 🔪
🚨 often no pseudomembranes on 🔦
🚨 can happen post-colectomy 🔪 in #smallbowel or #IPAA
#CDI in #IBD compared to general 👩👨🦱
⬆️⬆️ common (5-8x 🔺)
⬆️ community-acquired
⬆️ w/o antibiotic 💊 exposure
⬆️ colonization
⬆️⬆️ recurrence ☹️
⬆️ colectomy risk 🔪
🚨 often no pseudomembranes on 🔦
🚨 can happen post-colectomy 🔪 in #smallbowel or #IPAA
@MondayNightIBD @Spencerkelley7 @dunleavy_katie @SanjeevaniTomar @yaransarkis @RomyChamoun @BassiMehak @JosephHabibi_MD @DCharabaty @DSTEINGIMD @BeniwalPatelMD 3/
Testing for #CDI ⬇️
💩 GDH:
✅ detects organism
⬆️ sensitive
⬇️ specific
💩 PCR:
✅ detects genes that code for toxin
🚫 detect toxin
⬆️ sensitive
⬆️ specific
🚨 can over-diagnose
💩 EIA for toxin A/B:
✅ detects toxin
⬆️ specific
⬇️ sensitive
🚨 can under-diagnose
Testing for #CDI ⬇️
💩 GDH:
✅ detects organism
⬆️ sensitive
⬇️ specific
💩 PCR:
✅ detects genes that code for toxin
🚫 detect toxin
⬆️ sensitive
⬆️ specific
🚨 can over-diagnose
💩 EIA for toxin A/B:
✅ detects toxin
⬆️ specific
⬇️ sensitive
🚨 can under-diagnose
@MondayNightIBD @SobiaMujtabaMD @FezaRemziMD @DCharabaty 1/ 35 yo F panUC on IFX 10mg q4wk, admitted with abdo pain, hematochezia, malaise. T 39 BP 95/63 HR 110 FCP 900 mcg/g. Abdo distended, TTP; CT: colonic wall thickening+edematous mucosa. Cdiff neg; WBC 15, Hb 6. No improvement despite IVCS+Abx. Which surgery is indicated #B2BPoll
@MondayNightIBD @SobiaMujtabaMD @FezaRemziMD @DCharabaty 2/ Indications for colectomy in UC:
📌Elective:
📍UC refractory to medical Rx
📍Steroid-dependant UC
📍Unresectable dysplasia, CA
📍Complications from medical Rx
📌Emergency:
📍Toxic megacolon
📍Fulminant colitis
📍Perforation
📍Severe Bleeding
📌Elective:
📍UC refractory to medical Rx
📍Steroid-dependant UC
📍Unresectable dysplasia, CA
📍Complications from medical Rx
📌Emergency:
📍Toxic megacolon
📍Fulminant colitis
📍Perforation
📍Severe Bleeding
@MondayNightIBD @SobiaMujtabaMD @FezaRemziMD @DCharabaty 3/ What is a toxic megacolon?
🔺Transverse colon > 6cm
🔺AND one:
T>101.5° F
HR> 120
WBC>10.5
anemia
🔺AND one:
Dehydration
altered mental status
electrolyte abnormality
hypotension
💡Recall our #B2B tweetorial on ASUC👇🏽👇🏽👇🏽
🔺Transverse colon > 6cm
🔺AND one:
T>101.5° F
HR> 120
WBC>10.5
anemia
🔺AND one:
Dehydration
altered mental status
electrolyte abnormality
hypotension
💡Recall our #B2B tweetorial on ASUC👇🏽👇🏽👇🏽
🗣Not having a colon doesn’t change immune suppression.
❌These ideas do not correlate until another ingredient is added. Stop spreading this myth!
#ostomy #jpouch #colectomy
❌These ideas do not correlate until another ingredient is added. Stop spreading this myth!
#ostomy #jpouch #colectomy
More info from @SchwartzbergMD expressing ❌connection (unless underlying conditions/meds) between *just* colectomy and immune suppression. 👇🏽
Here’s more information about susceptibility & #ostomy/#Jpouch from @HolubarStefan. Ostomates (or jpouchers) don’t have a lower immune system *just* because they have an ostomy, BUT it’s imperative to keep strict hygiene. #IPAA https://t.co/bkeqMkcYRv
